J Int Acad Phys Ther Res 2019; 10(2): 1803~1809 www.iaptr.org ISSN 2092-8475 https://doi.org/10.20540/JIAPTR.2019.10.2.1803 Short-term Benefits of Mobilization for Patients with Non- Specific Neck Pains: Executive Function and Neck Pain Intensity Background: Cervical mobilization has been applied mainly for the improve - Wansuk Choi, PT, Prof. Ph.D a, ment of arm and neck movements and pain reduction, and little research has Seoyoon Heo, PT, Ph.D b, been done to improve the executive function. Since this kind of so-called aInternational University of Korea, Jinju, b mechanical neck pain is one of most common symptoms, there are contro - Kyungbok University, Pochen, Republic of Korea versial issues about this with spine alignment. Posteroanterior (PA) mobilization from the Maitland concept is a process of examination, assessment, and Received : 15 April 2019 treatment of neuromusculoskeletal disorder by manipulative physical therapy. Revised : 13 May 2019 Objective: To examine the short-term benefits of mobilization for patients with Accepted : 19 May 2019 non-specific neck pain. Design: Dual-group Pretest-Posttest Design from the Quasi-Experimental Address for correspondence research Wansuk Choi, PT, Ph.D Methods: Fourteen participants (male 8, female 6; 20’s of their age) with non- Department of Physical Therapy, International University of Korea, 965, specific neck pains which are distributed all the unilateral or bilateral body Dongbu-ro, Munsan-eup, Jinju-si, side were recruited. Participants were categorized to Neck Pain with Gyeongsangnam-do, Korea Movement Coordination Impairments (NPMCI) and Neck Pain with Mobility Tel: 82-10-9041-2769 Deficits (NPMD) groups according to the results of physical examination. E-mail: [email protected] Professional physical therapist who has over 15-years-of clinical experience applicated manipulative therapy for the neck pain, an occupational therapist only conducted evaluations; K-NDI (Korean version of the Neck Disability Index), VAS (Visual Analog Scale), BDS-K (Korean version of Behavioral Dyscontrol Scale) for decreasing possible adverse effects; there were no per - son who reported other symptoms followed 4 weeks from the trial. Results: In the NPMCI group, data analysis indicated statistical differences between the PA mobilization interventions in NDI and BDS-K; even though, pain was reduced in VAS, this is not a significantly differ. In the NPMD group, data analysis represented statistical differences between the PA mobilization interventions in NDI, VAS and BDS-K; the scores were represented to be increased or the pain got relief. Conclusions: PA mobilization techniques according to Maitland concept have beneficial effects in patients with neck pain and other clinical positive effects which included neck disability, pain itself and motor function of upper extremity. Key words : Posteroanterior mobilization, Manipulative therapy, Executive function, Neck pain INTRODUCTION non-ergonomic postures or even masticatory overuse 1) . Spine-related upper extremity pain or malfunction Neck pain might be the most considerable symp - is defined as the constellation of symptoms featured toms nowadays. It could be induced from other dis - by originated in the cervical into the upper arm with orders like temporomandibular disorders (TMD), or without specific neurologic signs 2) . weight issues, spine-related extremity symptoms, Non-specific neck pain (NP) is also known as pain 1803 Short-term Benefits of Mobilization for Patients with Non- Specific Neck Pains: Executive Function and Neck Pain Intensity in the posterior or lateral side of the neck near the patients with non-specific neck pains, and this is the spinous process of the cervical vertebra which is focus for this study. interference with basic activities of daily life, make lower quality of life as well as with the absence of neurological signs and specific pathologies; such as: METHODS sprain, tumor, infectious or inflammatory cervical 3) spondylolysis . Research design Clinical professionals have used manual therapy for relieving specific or non-specific neck pain. The This research contains case series and dual-group manual therapy or manipulative therapy, is an Pretest-Posttest Design from the Quasi- important technique concept of physical therapy, Experimental research. Each pre- and post-test for mostly used by physical therapists to treat with many the dual-group was conducted for examining the kinds of musculoskeletal pain and disability; it may sort-term outcomes of the cervical spine manipula - include handling and manipulating of muscles, joint tive mobilization techniques to investigate executive mobilization and joint manipulation 4, 5) . The Maitland function and neck pain intensity. One occupational and Kaltenborn mobilization techniques are effective therapist, physical therapist, and an assessor were for improving pain and range of motion in frozen involved in this study. The physical therapist handled shoulder patients 6) . with the process of all the trials; the occupational The international Maitland Teachers Association therapist assessed pain and motor function of upper (IMTA) emphasized the Maitland concept would be extremities; another assessor recorded whole proce - one of a process of examination, assessment, and dures. All the experimental procedure was fully treatment of neuromusculoskeletal disorder by explained for researchers and written informed con - manipulative physical therapy 4) . Physical therapist sent was provided for the participants. mostly accepted Grades I and II of Maitland mobiliza - tion techniques for handing joints limited by pain 6) ; Subjects generally, the high grades regards as Grade Ⅲ-Ⅳ are targeted to manage the stiffness (resistance) Fourteen Participants with mechanical neck pains dominant problems, while the small grades (I-II) are which are distributed all the unilateral or bilateral used to treat the pain dominant problems 4) . neck side; they had had the pain on the neck at least There have been reported contraindications for one month ago form the research. Their neck pains using manipulative therapy or manual therapy for were greater than second grade from the VAS that specific or non-specific neck pain; some reports sug - could be have clinical effects and clinically valuable. gested that relatively mild adverse effects occur in Participants were excluded if they had (1) a positive 30% to 61 % of all patients 7) . Other case-control neurologic test; (2) any contraindications to mobiliza - studies suggested a causal relationship between tion (eg. inflammatory arthropathy, disease of cauda spinal manipulative therapy and the adverse effect 7) . equina and/or, spinal cord, presence of malignancy) ; Nevertheless, the manipulative therapy is still con - (3) history of cervical spine surgery; (4) previous his - sidered one of the most crucial methods for decrease tory of fractures and significant traumas on the cer - specific or non-specific neck pain these days. vical spine, and (5) undergone spinal mobilization or Executive function is regards as sort of cognitive manipulation therapy within two months before the function or cognitive processes that are necessary for research procedures. The general symptoms of the the cognitive control of behavior: selecting and suc - NPMCI group are: (1) mechanism of onset linked to cessfully monitoring behaviors that facilitate the whiplash or trauma; (2) associated upper extremity or attainment of chosen goals, but also, it is closely shoulder girdle pain; (3) referred to nonspecific con - related to upper arm motor function. It is necessary cussive symptoms and signs; 4) nausea / dizziness and to be considered with cognitive function and upper 5) hypersensitivity to mechanical, light stimuli, odor, extremity motor function 8) . acoustic, or thermal; headache, memory, or concen - There are many of studies in this matter, especially tration difficulties; heightened affective distress; pain relief, but we could find few researches that are confusion. The characteristics of the NPMD group are dealing with executive function or specific motor as follows: (1) limitation of neck movement continu - function of the upper extremity. ously reproduces the symptoms; (2) unilateral / cen - It is crucial that consider executive function with tral and/or neck pain, and 3) referred upper extremity motor function of upper arm by mobilization for pain or shoulder girdle pain 9) . 1804 W.S. Choi, S,Y. Heo Intervention Procedures tions per second. The treatment for 3 minutes was set as one set and three sets were performed. An eligible physical therapist who has over 15- Participants rested for one minute between sets. years-of clinical experience in manual therapy was involved in this study. Initially, the participants were Outcome Measures asked to fill out the Korean version of the Neck Disability Index (K-NDI) questionnaires and demo - K-NDI (Korean version of the Neck Disability Index) graphics chart. An assessor collected the pretreat - The NDI was developed for assess the neck pain- ment data, which included the typing speed, coordi - induced disability by Howard Vernon in 1989. The nation index (e.g., BDS-K), the body pain location NDI was invented as a modification of the Oswestry chart, pain on the most painful movement, and neck low back pain disability index with the permission of pain at rest (e.g., VAS). After the procedure, the the original author 10) . Total of the 10 items scores physical therapist who did not have the information